May 1989

Liver AbscessThe Need for Complete Gastrointestinal Evaluation

Author Affiliations

From the Departments of General Surgery (Dr Rossi) and Colon and Rectal Surgery (Dr Schoetz), Lahey Clinic Medical Center, Burlington, Mass. Dr Cohen is now in private practice in Hartford, Conn. Dr Martin is now with the Department of Surgery, New England Deaconess Hospital, Boston, Mass.

Arch Surg. 1989;124(5):561-564. doi:10.1001/archsurg.1989.01410050051009

• The cause of liver abscess is frequently obscure at initial presentation. We reviewed the medical records of 20 patients with pyogenic liver abscess over a 6-year period from 1981 to 1987. Liver abscess was suspected in only 3 patients on admission; the most common initial diagnosis was fever of unknown origin. Subsequently, the origin of the abscess was found to be intestinal in 7 patients, pancreatobiliary in 11 patients, and cryptogenic in 2 patients. Eleven patients underwent percutaneous transhepatic drainage of the abscess as the initial treatment, while open operation was the initial treatment in 9 patients. Percutaneous transhepatic drainage was ultimately successful in only 4 patients (36%). In the absence of an obvious pathologic condition of the biliary tract, all patients should undergo full gastrointestinal evaluation.

(Arch Surg. 1989;124:561-564)